Kelly Kemak, LCGC

Primary specialty

Genetic Counselor (M.S.)Taxonomy code 170300000X

Practice address

125 Queens Rd Ste 560
Charlotte, NC 28204-3215

Phone

(980) 302-6270

Fax

(980) 302-6275

NPI assigned

Oct 3, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kkemak815814@direct.novanthealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Moses H. Cone Memorial Hospital Operating Corporation

  • Maternal & Fetal Medicine Physician
  • Greensboro, NC
  • NPI 1891351847
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1538524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629244800000",
    "number": "1215412465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "980-302-6270",
            "fax_number": "980-302-6275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 QUEENS RD STE 560",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043215",
            "telephone_number": "980-302-6270",
            "fax_number": "980-302-6275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEMAK",
        "first_name": "KELLY",
        "credential": "LCGC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-03",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170300000X",
            "taxonomy_group": "",
            "desc": "Genetic Counselor, MS",
            "state": "DE",
            "license": "CG-0000193",
            "primary": false
        },
        {
            "code": "170300000X",
            "taxonomy_group": "",
            "desc": "Genetic Counselor, MS",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kkemak815814@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "125 Queens Rd Ste 560",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282043215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Timothy White Kelly, MED ATC-L
• Kelsey Pheifer Nutrition LLC
• Jennifer Lynn Kelso, MD
• Rebecca Lynn Kelso
• Estelle Catherine Kelty
• Hayat Kemal
• Amy Gunn Kemmerlin, NP
• Kristen Kemp, BSN, RN
• Reginald Benjamin Kemp
• Laurence Byron Kempton, MD

• Genetic Counselor (M.S.) in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Genetic Counselor (M.S.) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.